Impact of COVID-19 on the patient visits in ortho emergency at a tertiary care centre

Background: COVID-19 pandemic effects are still being elucidated. Stay-at-home orders issued during peak of COVID-19 and social distancing as lockdown measures compounded with COVID-19 concerns have caused significant disruptions in daily life. One notable effect of these variables may be a change in the number of emergency department (ED) visits. This study aims to investigate the effects of COVID-19 on ED visits, and possible reasons for changes.Methods: Retrospective analysis using data for ED visits and procedures performed in the orthopaedics department of GMC Jammu were collected from the record section of GMC Jammu for four months prior and post implementation of lockdown and results were deduced with regards to the comparison in the number of visits, admissions and surgeries done pre and post-lockdown period.Results: The mean number of ED visits/admissions per day for the last four months of available data post lockdown due to COVID-19 pandemic was significantly less than the four months prior to COVID-19 pandemic.Conclusions: A number of factors have likely contributed to the substantial decrease in ED visits observed in this study. In light of these findings, it is important to raise patient awareness regarding conditions that require urgent ortho consultation so as to avoid any type of deformity/disability whatsoever.

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OPTIONAL VACCINE UTILIZATION HAS A MALE GENDER PREFERENCE – A RECORD BASED ANALYSIS FROM A TERTIARY CARE CENTRE OF EASTERN INDIA

10.1101/2020.05.17.20072173 ◽

2020 ◽

Author(s):

Sandeep Kumar Panigrahi ◽

Anumita Maiti ◽

Venkatarao Epari

Keyword(s):

Hepatitis A ◽

Tertiary Care ◽

Secondary Data ◽

Gender Disparity ◽

Measles Vaccine ◽

Care Centre ◽

Tertiary Care Centre ◽

Important Place ◽

Universal Immunization Program ◽

The Mean

Background And Objectives: Optional vaccines find an important place in immunization today. This study attempts to find out the trend of optional vaccine utilization, over the past three years in the immunization clinic of a tertiary care centre and to find out the association of gender disparity with the utilization of these vaccines. Methods: The retrospective study was conducted during October to December 2016 using the register based secondary data of October 2013 to September 2016. Month wise utilization of optional vaccines (Pneumococcal, influenza, typhoid, varicella, hepatitis A and MMR) and measles was captured. Analysis was done using Stata 12.1 SE. Results: An increasing trend of utilization was seen for all vaccines including optional vaccines. The mean doses received by male children was significantly more for all optional vaccines (unlike all vaccines taken together) as well as for individual vaccines like Pneumococcal, influenza, typhoid, MMR, hepatitis A (p<0.05), but not for varicella and measles vaccine (p>0.05). Conclusion: Gender disparity (preference for male children) was present for all optional vaccines except varicella, and not in case of measles vaccine used in universal immunization program selected as control.

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Factors affecting breastfeeding techniques among postnatal mothers: an experience in a tertiary care centre

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20192840 ◽

2019 ◽

Vol 6 (7) ◽

pp. 2991

Author(s):

Shubhra Agarwal Gupta ◽

Mini Sharma ◽

Abha Ekka ◽

Nirmal Verma

Keyword(s):

Tertiary Care ◽

Mode Of Delivery ◽

Delivery Mode ◽

Care Centre ◽

Interventional Study ◽

Tertiary Care Centre ◽

Factors Affecting ◽

Number Of Factors ◽

Lactating Mothers ◽

Postnatal Mothers

Background: Large number of factors related to mother and neonates can affects breastfeeding technique. Therefore, the main objective of this study was to know the association of maternal and neonatal characteristics that can affect correct breastfeeding techniques after intervention among post natal mothers admitted in a tertiary care centre.Methods: An institutional-based pre and post interventional study design was used. 414 lactating mothers were contacted during study period.Results: It was found that parity, time of delivery, mode of delivery, birth weight were statistically significantly associated with correct breast feeding technique.Conclusions:This study highlights that correct breastfeeding technique depends on various factors related to mother and neonate.

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Placental cord drainage during third stage of labour: a randomized control trial at a tertiary care centre

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20200890 ◽

2020 ◽

Vol 9 (3) ◽

pp. 1143

Author(s):

Megha Chaudhary ◽

Maitri Shah ◽

Nitin Makwana

Keyword(s):

Blood Loss ◽

Randomized Control Trial ◽

Tertiary Care ◽

Normal Vaginal Delivery ◽

Control Group ◽

Care Centre ◽

Tertiary Care Centre ◽

Third Stage ◽

The Mean ◽

Randomized Control

Background: Labour is a physiological process, but it is often associated with morbidity and mortality, with the most common cause being blood loss. Primary postpartum hemorrhage is commonly defined as a blood loss of 500 ml or more within 24 hours after normal vaginal birth. A prolonged third stage of labour (more than 20 min) is associated with postpartum hemorrhage. The present study was undertaken with the objective of assessing efficacy of placental cord drainage (PCD) during active management of third stage of labour.Methods: This is a randomized control trial in which full term primi gravida who were expected to have normal vaginal delivery, admitted in labour room of a tertiary care centre were evaluated for inclusion in the study. Total 126 participants were enrolled after having normal vaginal delivery. In study group (n = 63), placental cord drainage was used for management of third stage of labour while in control group (n = 63), third stage was managed without PCD.Results: The mean difference in duration of third stage of labour in study and control group was 1.79 minute and the mean difference in blood loss during third stage of labour in both groups was 57.86 ml which was statistically significant.Conclusions: The results of this study show small positive effects from cord drainage in reducing the length of the third stage of labour and in reducing the amount of blood loss when compared with those without cord drainage. The observed changes may be of clinical significance in reducing third stage related complications.

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Study on electrolyte disturbances in dengue fever in a tertiary care centre

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20194725 ◽

2019 ◽

Vol 6 (6) ◽

pp. 2504

Author(s):

Poornima Shankar ◽

Nithya E. ◽

Kavya C.

Keyword(s):

Dengue Fever ◽

Serum Sodium ◽

Demographic Data ◽

Tertiary Care ◽

Clinical History ◽

Mean Value ◽

Care Centre ◽

Tertiary Care Centre ◽

Electrolyte Disturbances ◽

The Mean

Background: Dengue is a mosquito borne disease of significant morbidity and mortality. Dengue viral infection has been shown to be associated with electrolyte abnormalities and renal dysfunction. It is necessary to have a thorough understanding about electrolyte disturbances in Dengue, so as to predict, diagnose and treat them accordingly. The aim and objective of this study is to study electrolyte disturbances in dengue fever and its correlation with severity of dengue fever.Methods: This study was performed in a tertiary care centre in Bangalore , India. The study was a prosspective observational study. 200 Patients diagnosed with Dengue were enrolled for the study. Patients demographic data, clinical history, electrolyte values were recorded and analysed.Results: In our study majority of patients belonged to 5-12 years age group ie 47%. Fever was found to be the most common presentation in 196 patients (98%) followed by myalgia in 142 patients (71%), headache in 102 patients (51%), skin rash in 43 patients (21.5%). The mean value of serum sodium observed was 133.69 mEq/L and of serum potassium was 3.58 mEq/L and there was positive and significant correlation between difference in serum sodium and potassium levels with severity of dengue fever.Conclusions: Dyselectrolytemia is more common in dengue fever. Serum electrolytes testing early is very important in dengue patients during management so that if abnormalities are found, they can be appropriately managed as some of these abnormalities may lead to increased severity as well as mortality.

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Plastibell circumcision in neonates and infants at tertiary care centre

International Surgery Journal ◽

10.18203/2349-2902.isj20181135 ◽

2018 ◽

Vol 5 (4) ◽

pp. 1488

Author(s):

Nandkishor D. Shinde ◽

Mohammad Moinuddin ◽

A. N. M. Owais Danish

Keyword(s):

Prospective Study ◽

Surgical Procedure ◽

Tertiary Care ◽

Care Centre ◽

Inclusion Criteria ◽

Medical Sciences ◽

Tertiary Care Centre ◽

Surgical Time ◽

The Mean ◽

Neonates And Infants

Background: Circumcision is the most common surgical procedure in children worldwide. The aim of this study was to study the safety and complication of Plastibell circumcision in neonates and infants.Methods: This prospective study of 420 male children less than 1 years who underwent Plastibell circumcision for religious or cultural indication in the Department of Surgery at KBN Institute of Medical Sciences, Kalaburagi, during February 2016 to January 2018. Children were divided into two groups; neonates (0 to 4 weeks) and infants (5 weeks to1 year). Parents were given specific instructions on care of the device on discharge and followed up on day 3 and on day of separation of the Plastibell.Results: During the study period, 420 cases of Plastibell circumcision fulfilling the inclusion criteria were included and analyzed. Out of the total cases, 120 (28.57%) were neonates, whereas the remaining 300 (71.42%) were infants. Mean surgical time was 4±2 minutes. The mean number of days for Plastibell to separate was 6.2 days, Plastibell ring separation in neonates earlier (3 days to 7 days) as compared to infants (5 days to 12 days). Out of the total 420 cases 65 (15.47%) cases developed minor complications. In neonates, out of 120 cases only 05 (4.16%) developed complications. In infants, out of 300 cases, 60 (20%) developed complications.Conclusions: Neonates had shorter time for the Plastibell to separate and with fewer complications than infants. Though complications were present, they were few and could be managed easily. Plastibell circumcision is safe in neonates and infants.

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A study of visceral adiposity index as a diagnostic index in gestational diabetes mellitus in a tertiary care centre

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20171435 ◽

2017 ◽

Vol 6 (4) ◽

pp. 1561

Author(s):

Padmalatha Dakshnamurthy ◽

Shaanthy Gunasingh Thangiah Kasirajan ◽

Indhumathi Nachiyar ◽

Mangala Geetha ◽

Kannan Rajendran

Keyword(s):

Pregnant Women ◽

Tertiary Care ◽

Visceral Adiposity ◽

P Value ◽

Visceral Adiposity Index ◽

Care Centre ◽

Tertiary Care Centre ◽

Adiposity Index ◽

The Mean ◽

Diagnostic Index

Background: Gestational Diabetes Mellitus is an emerging problem which affects pregnant women all over the world particularly in India. Early detection reduces adverse maternal and foetal outcome. Elevated central adiposity is a modifiable risk factor for abnormal glucose homeostasis in pregnancy and GDM. The Visceral Adiposity Index (VAI) is a gender-specific index of fat distribution and assessment.Methods: It is a hospital based, case control study among the subjects who attended a tertiary care centre. cases were 30 pregnant women newly diagnosed with GDM in their 2nd trimester, and Controls were 30 apparently healthy pregnant women in their 2nd trimester without risk factors for GDM such as obesity and family history for diabetes. Visceral Adiposity Index (VAI) was calculated using the formula (Waist circumference (WC)/ {36.58 +(1.89xBMI)}) x(TGL/0.81) x (1.52/HDL) where WC is expressed in cm, BMI in Kg/m2, TG in mmol/L, HDL in mmol/L.Results: The mean age of patients with GDM was higher when compared to controls (28.17 ± 3.34vs 24.40±3.07) and this difference was statistically significant (p value < 0.0001). The average weights were significantly different. The mean Body Mass Index (BMI) and waist circumference (WC) was 23.59 ± 4.19 and 88.46 ± 7.10 respectively among controls and 29.85 ±4.52 and 102.12 ± 6.96 respectively among GDM patients and these differences were highly significant (p value<0.0001). The lipid profile of these patients showed a significantly higher value of Triglycerides among patients.Conclusions: This study correlates GDM with Visceral adiposity index and found that the index to be elevated in the GDM group. The increased VAI in GDM patients shows their elevated adipose tissue distribution. VAI is less invasive and cost effective, can be used as a diagnostic index in GDM.

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Current placenta previa management and outcome in a rural tertiary care centre

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20171975 ◽

2017 ◽

Vol 6 (5) ◽

pp. 2050

Author(s):

Reena Sood ◽

Swati Sharma ◽

Madhu Nagpal ◽

Madhurima Arora

Keyword(s):

Risk Factors ◽

Placenta Previa ◽

Tertiary Care ◽

Care Centre ◽

Tertiary Care Centre ◽

Gestational Age At Delivery ◽

History Of ◽

Obstetric Services ◽

The Mean ◽

Present Case Study

Background: The reported incidence for placenta previa averages 0.3% or 1 case in 300 to 400 deliveries. Multiparity, advanced maternal age, cigarette smoking, previous caesarean delivery, history of abortions or uterine surgical procedures are some of the risk factors contributing to the development of placenta previa. Massive obstetrical haemorrhage in placenta previa is associated with severe maternal morbidity and mortality. A significant number of mothers can be saved if right approach of management is followed in placenta previa.Methods: The present case study is a retrospective analysis carried out in a tertiary care centre to study the risk factors and maternal and perinatal outcome in cases of placenta previa. The study included antenatal patients diagnosed as placenta previa on sonography at or >26 weeks of pregnancy. Data was compiled and statistically analysed.Results: Incidence of Placenta Previa in our study was 0.54%. 73.2% patients had history of previous cesarean sections. 53.6% patients were referred from outside. 98.2% patients delivered by caesarean section. Obstetric hysterectomy was required in 3.5% of total cases. 10.7% cases required the ICU admission after delivery. There was no maternal mortality in the study group. The mean gestational age at delivery was 35±2.4weeks. The mean APGAR at 5 min was 9±2.2.Conclusions: Increasing rates of caesarean sections in present era indicate that incidence of Placenta Previa is expected to rise. Good antenatal care, availability of emergency obstetric services, infrastructure, blood bank facility, HDU and ICU care and NICU services can improve maternal and neonatal outcome.

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Efficacy of bipolar hemiarthroplasty in the elderly people: a study in a tertiary care centre

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20171573 ◽

2017 ◽

Vol 3 (3) ◽

pp. 396

Author(s):

G. Ramachandra Reddy ◽

P. N. Prasad

Keyword(s):

Elderly Patients ◽

Tertiary Care ◽

The Elderly ◽

Bipolar Hemiarthroplasty ◽

Common Complication ◽

Care Centre ◽

Tertiary Care Centre ◽

Type Iv ◽

Prosthetic Implant ◽

The Mean

Background: Intertrochanteric fractures are associated with severe displacement and comminution are very common among the elderly patients especially women. Hemiarthroplasty is a procedure, where the head of the femur is replaced with a prosthetic implant. This study was performed to evaluate the efficacy of the bipolar hemiarthroplasty among the elderly patients with intra capsular fractures.Methods: Bipolar hemiarthroplasty with or without cement was performed on 77 patients above the age of 60 years with femoral neck fractures.Results: Out of the 77 patients, 79.2% were females and 20.8% were males. The mean age of all the patients was 68.4 years. Type IV was found to be most common among the elderly. The outcome of the surgery was excellent in more than 75% of the cases. Only one patient had a poor outcome. The most common complication of the surgery was limb shortening in 5.2% patients followed by superficial infections in 2.6%. Conclusions: Bipolar hemiarthroplasty for the unstable hip fractures in the elderly has good results with early mobilizations and minimal complications. This ultimately affects the general health of the patients and reduces morbidity and mortality.

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Impact of COVID-19 Outbreak in Dental Service Utilization Reported by Patients Visiting a Tertiary Care Centre: Mixed Quantitative-qualitative Study

10.21203/rs.3.rs-59399/v1 ◽

2020 ◽

Author(s):

Ashish Shrestha ◽

Tarakant Bhagat ◽

Santosh Kumari Agrawal ◽

Ujwal Gautam

Keyword(s):

Service Utilization ◽

Dental Treatment ◽

Tertiary Care ◽

Dental Service ◽

Care Seeking ◽

Care Centre ◽

Tertiary Care Centre ◽

Cross Sectional ◽

Number Of Factors ◽

Structured Questionnaire

Abstract Background: COVID-19 poses a major public health calamity. Its wider impact on health service utilization is yet to be studied. The study aims to assess dental problems faced by patients during the COVID-19 outbreak and the possible reasons in failing to seek dental careMethods: A cross-sectional quantitative-qualitative design was employed to assess the outcomes among patients reporting to a tertiary care centre. Participants were selected by convenient sampling and interviewed using structured questionnaire. Responses were transcribed, translated and coded before analyzing for the themes by thematic analysis. Quantitative component of the study was analyzed by descriptive and inferential methods.Result: Mean age of the participants was 43.7 years (SD: 16.1). Most of them (63%) reported not having had an oral examination in the past year while 62% reported being unable to seek dental treatment during the pandemic. Pain, sequelae of pain and other self-perceived urgent causes were identified as the major problems faced by the participant. Similarly, the reasons for not being able to seek dental treatment were grouped as fear of transmission, lack of transportation and lockdown, unavailability of health services, misinformation, lack of communication from hospital regarding its services, and deferred treatment by the hospitals.Conclusion: Pain remains the ultimate trigger for care seeking behaviour. Dental service utilization was reported to be influenced by a number of factors during COVID-19. The pandemic seemed to add up to the already pre-existing dilemma in seeking dental care. A conceptual framework has been suggested to aid further researches in the future for looking into the impacts from such pandemics.

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